In response to AHRQ Special Emphasis Notice (SEN NOT-HS-15-005) and in recognition of the need for new evidence on safe health information technology (HIT) practices, the goal of the proposed project is to identify pragmatic approaches to safe electronic health record (EHR) use in primary care. This issue is particularly salient in small primary care practices with minimal resources devoted to HIT. In this application we propose such exploration among exemplar practices in the Primary Care Practices Research Network (PPRNet), an AHRQ-sponsored Center for Primary Care Practice-Based Research and Learning. Exemplar practices are defined as those achieving high performance on a broad set of clinical quality measures. The project aims to: 1) conduct focus group interviews with primary care clinicians from 20 small exemplar practices to identify their perspectives on recommended practices from the Office of the National Coordinator for HIT SAFER guides, their adoption of these practices, and their impact on EHR safety; 2) conduct key informant interviews with EHR vendor experts to provide additional perspectives on strategies associated with safe HIT; and, 3) use qualitative transcript- based analyses to develop a taxonomy of pragmatic key strategies and best practices for safe EHR use in small primary care practices. Findings from this study should help tens of thousands of small primary care practices in the United States prevent patient safety issues resulting from their adoption of EHRs.